Individual
ELIZABETH WADE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3108 THORNRIDGE DR, GRAND BLANC, MI 48439-8987
(989) 590-3554
Mailing address
3108 THORNRIDGE DR, GRAND BLANC, MI 48439-8987
(989) 590-3554
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
4703050082
MI
Other
Enumeration date
11/26/2013
Last updated
11/26/2013
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